Racial and Ethnic Factors

The roles of race, ethnicity, and culture as risk or protective factors for developing posttraumatic stress symptoms (PTSD) following a trauma have been widely researched. Although the subtleties regarding the definitions of race, ethnicity, and culture have been discussed elsewhere and go beyond the scope of this brief entry, numerous reports in the adult trauma literature highlight the relative impact of these constructs on traumatic stress outcomes. The often-cited empirical review by Norris and Elrod presents evidence to support the notion that minority groups tend to display more distress and/or fare poorly compared with majority groups following three types of traumatic events, namely natural disasters, technological disasters, and mass violence. Similarly, others have found strong group differences in the prevalence of PTSD following Hurricane Andrew: Latino participants had the highest prevalence rate (38%), followed by African Americans (23%), and Caucasians with the lowest prevalence rate (15%). In the aftermath of the September 11, 2001, terrorist attacks, minorities (i.e., Hispanics and African Americans) experienced significantly higher levels of [Page 514]PTSD than did Caucasians as reported by Galea and his colleagues. Evidence also suggests that minority groups, particularly African Americans, experience more lifetime traumatic events compared with Caucasians and Hispanics.

Some similar findings have been reported within the child and adolescent trauma literature. For instance, ethnic differences were present with African American youth reporting more psychological distress, as measured by PTSD symptoms, than with other minority youth or Caucasian youth following Hurricane Hugo. In addition, La Greca and associates have reported that minority youth have been less likely to experience declines in levels of PTSD.

Yet, noteworthy discrepancies in the trend for minority racial/ethnic groups have also been reported. For example, Galea and colleagues examined the prevalence of a variety of mental health difficulties among adults in New Orleans and surrounding areas (Alabama, Mississippi, etc.) and found that individuals of Hispanic origin in New Orleans were less likely to report mild/moderate or severe mental illness compared with a non-Hispanic/White reference group. This may result from the small number of respondents in the minority subsample.

However, Jones and colleagues found no differences with regard to race-related difficulties among youth 6 months after Hurricane Andrew. This and related findings may be because the exact role of ethnicity is unclear for youth, and consequently, contradictory findings have emerged. Nevertheless, it is obvious that additional research on both adult and child samples is needed to better understand the role of race and ethnicity.

Although several studies discuss the impact of minority status on mental health sequelae following a trauma, few, if any, have specifically examined samples of Asian individuals. This represents a major gap in the trauma literature. Often, this subsample has not yielded enough participants to be examined as a particular ethnicity group. As such, it is commonplace for Asian individuals to be re-coded into an “other” category during data analysis or simply excluded from analyses. This practice leaves significant gaps in our understanding of the impact of trauma on the Asian community. The few studies that have examined Asians have found lower rates of most mental health issues, including PTSD, after a trauma. It is also worth noting that the within-group variability between the more than 40 subgroups of the Asian population (Chinese, Japanese, Koreans, Vietnamese, Cambodians, etc.), considerable heterogeneity across cultures, ethnic backgrounds, and native languages exists as reported by Pole and his colleagues. Such differences may account for the variability in the Hawaii Vietnam Veterans Project where Japanese Americans experienced the lowest rates of PTSD, followed by Chinese Americans, and Native Hawaiians.

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